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High-flux Hemodialysis Improved Puimonary Function in Maintenance Hemodialysis Patients

Author: ChenRuiJuan
Tutor: LiangMeng
School: Anhui Medical University,
Course: Nephrology
Keywords: High flux hemodialysis Low flux Hemodialysis Pulmonary function Nourishment Microinflammation Anaemia
CLC: R459.5
Type: Master's thesis
Year: 2013
Downloads: 7
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Abstract

Background and objective With the rapid development of the socio-economicand the implementation of the medical and health in china,we have gradually achievethe goal of universal access to basic health services, and improve their health.MHD isthe earliest and the most widely used treatment of renal replacement. More and morepatients with ESRD gained replacement therapy, and their survival and quality of lifehas been significantly improved. MHD is still the main renal replacement treatment,accounting for more than80%of the total number of dialysis.Although the extendedsurvival of patients, but HD treatment also can not completely replace the physiologicalfunctions of the kidney. HD could not prevent the deterioration of the original diseaseand difficult to change the progress of multiple organ damage caused by kidneyfailure.Where the lung is one of the most commonly affected organ in the MHD patients.The damage of the lung function is various in the Uremic dialysis patients, bothdecreased of ventilation function and dispersion function, the size of the airway isgoverned by involving. There are mang factors can damage lung function with patients,such as sodium and water retention, electrolyte and acid-base balance disorders, uremictoxins, inflammation and malnutrition.Pulmonary pathological changes mainlynon-infectious pulmonary edema, the histopathological changes can be divided into thecapillary type and artery type. The pathological changes of the former is the same asinterstitial pneumonia, the latter is characterized by bleeding and fiber exudative. At thesame as, alveolar space filled with protein components that is rich in eosinophilic exudate, hyaline membrane formation can be seen along the alveolar walls. The reasonmay be uremia poisoning factors lead to pulmonary capillary hyperpermeability.Chronic renal failure can also cause lung calcification, pathological changes in the lungtissue hardens alveolar septa widened due to calcification and can also merge fibrosis.Above all pathological changes can cause the decline in vital capacity and diffusiondysfunction. The study showed that the best treatment of impaired lung function areblood purification treatment. However, at home and abroad the lack of reports ofhigh-flux dialysis effect lung function in patients on maintenance dialysis.This study was designed by prospective and group-control method to study thehigh-flux dialysis on anemia, micro-inflammation and nutritional status, to explore theimpact of high-flux dialysis in uremic dialysis patients with lung function.Methods Sixty-four cases of chronic hemodialysis patients were randomlydivided into treatment group(group A) and control group(group B). Each group had32patients and they were followed up for6months.The HFHD were used in groupA,while the LFHD were used in group B. Two groups of patients were compared beforeand after dialysis treatment0months respectively, in FEV1.0, MMEF, V50in threechanges of pulmonary ventilation function index. Hb、hs-CRP、IL-6、TNF-αandMAMC、FEV1、MMEF、V50ventilation indicator changes were determined6monthsafter treatment.Results (1)After HFHD and LFHD, values of FEV1、MMEF and V50aresignificantly higher than those before blood dialysis，but those index had no apparentchanges between group A and B；(2)6months after therapy,the level ofHb,Alb,PAB,MAMC，FEV1，MMEF，V50were markedly elevated and the level ofhs-CRP、IL-6、TNF-α were markedly reduced in group A.but those index had noapparent changes in group B.Conclusion Hemodialysis is efficacious for improving pulmonary function inMHD patients.HFHD is highly efficacious for improving Hb,Alb,PAB,MAMC， FEV1，MMEF，V50and reducing hs-CRP、IL-6、TNF-α.It is superior to low-fluxhemodialysis in efficacy and safety.The probable mechanisms are that high-fluxhemodialysis could efficiently remove large and medium-sized molecules(mainlycytokine) and greatly improved patient’s anemia and nutrition.

High-flux Hemodialysis Improved Puimonary Function in Maintenance Hemodialysis Patients

Abstract

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